Ferrous fumarate
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Ferrous Fumarate: Efficacy, Bioavailability, and Applications
Introduction to Ferrous Fumarate
Ferrous fumarate is a widely used iron supplement, often recommended for fortifying foods and treating iron deficiency anemia. It is favored for its good sensory properties and relatively high bioavailability compared to other iron compounds.
Bioavailability of Ferrous Fumarate vs. Ferrous Sulfate
Comparative Studies in Different Populations
Research comparing the bioavailability of ferrous fumarate and ferrous sulfate in non-anemic Mexican women and children found no significant differences in iron absorption between the two compounds. The relative bioavailability (RBV) of ferrous fumarate was 86% in women, 97% in infants, and 106% in young children, indicating that ferrous fumarate is as well absorbed as ferrous sulfate in these groups .
Iron Absorption in Infants and Young Children
Despite earlier studies suggesting that ferrous fumarate is only 30% as well absorbed as ferrous sulfate in young children, more recent findings indicate that ferrous fumarate can effectively prevent iron deficiency in iron-replete infants and young children. However, iron-deficient children may absorb iron from ferrous fumarate less efficiently than from ferrous sulfate, necessitating higher doses of ferrous fumarate in complementary foods for these populations .
Treatment of Anemia with Ferrous Fumarate
Microencapsulated Ferrous Fumarate Sprinkles
A study in rural Ghana evaluated the use of microencapsulated ferrous fumarate plus ascorbic acid (sprinkles) compared to ferrous sulfate drops for treating anemia in infants. Both treatments resulted in similar rates of successful anemia treatment, with minimal side effects. The ease of use of sprinkles may improve adherence to treatment compared to traditional drops .
Intravenous Iron Sucrose vs. Oral Ferrous Fumarate in Pregnancy
In pregnant women with iron deficiency anemia, intravenous iron sucrose was found to be more effective than oral ferrous fumarate in increasing hemoglobin and serum ferritin levels. This suggests that while ferrous fumarate is useful, intravenous iron may be a better option for more severe cases of anemia during pregnancy .
Fortification of Foods with Ferrous Fumarate
Infant Cereals and Complementary Foods
Ferrous fumarate is recommended for fortifying infant cereals and complementary foods due to its high bioavailability and minimal impact on taste and appearance. Studies have shown that ferrous fumarate and ferrous succinate are highly effective iron sources for fortification, without causing fat oxidation or discoloration .
Chocolate Drink Powder
An evaluation of ferrous fumarate as an iron fortificant in chocolate drink powder found it to be organoleptically acceptable and more effective in iron absorption compared to ferrous sulfate and ferric pyrophosphate, especially when not reconstituted with boiling liquids .
Enhancing Iron Absorption
Role of Ascorbic Acid
The presence of ascorbic acid (vitamin C) can enhance the absorption of iron from ferrous fumarate. For instance, orange juice, which contains ascorbic acid, significantly increased iron absorption from ferrous fumarate in small children compared to apple juice, which lacks ascorbic acid .
Safety and Side Effects
Intestinal Inflammation
While ferrous fumarate is generally safe, a study on rats with DSS-induced colitis showed that low-dose oral ferrous fumarate could aggravate intestinal inflammation. This suggests that caution may be needed when using ferrous fumarate in individuals with pre-existing intestinal conditions .
Toxicity Comparisons
Comparative studies on the toxicity of various iron compounds have shown that ferrous fumarate is less toxic and irritant than ferrous sulfate and gluconate, making it a safer option for long-term use .
Conclusion
Ferrous fumarate is a highly effective and well-tolerated iron supplement suitable for fortifying foods and treating iron deficiency anemia. Its bioavailability is comparable to ferrous sulfate, and it offers advantages in terms of sensory properties and safety. However, its efficacy can be influenced by factors such as the presence of ascorbic acid and the specific needs of iron-deficient populations. Further research is needed to optimize its use in different dietary and clinical contexts.
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